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吕春儿,徐涛.慢性阻塞性肺疾病合并腰疝2例及文献复习[J].浙江中西医结合杂志,2018,28(11):
慢性阻塞性肺疾病合并腰疝2例及文献复习
Chronic obstructive pulmonary disease associated withSlumbar hernia: Two cases report and review of literaturesHao Rui, Weng Xudong, Xu Tao,
投稿时间:2018-04-14  修订日期:2018-07-20
DOI:
中文关键词:  慢性阻塞性肺疾病  腰疝
英文关键词:Chronic obstructive pulmonary disease  Lumbar hernia
基金项目:
作者单位E-mail
吕春儿* 鄞州人民医院 lvce203@163.com 
徐涛   
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中文摘要:
      目的:探索慢性阻塞性肺疾病和腰疝之间的相关性。方法:对2例确诊的慢性阻塞性肺疾病合并腰疝的患者的诊治经过进行回顾性分析,并通过文献检索复习此类疾病的临床特征。结果:病例1:患者,因“反复咳嗽、咳痰,呼吸急促7年”到我院呼吸科就诊。肺功能检查显示FEV<sub>1</sub>/FVC60% 、FEV<sub>1</sub>% 55%。胸部CT显示两肺肺气肿。腹部查体可见右腰区有一个直径6x4cm的可复性肿块腹部CT支持腰疝诊断。患者对症治疗后呼吸道症状改善明显,病人拒绝行手术出院。病例2:患者,因“发现左侧腰背部无痛性肿块2年”收入我院。患者有慢性阻塞性肺病病史10年,肺功能测试示FEV<sub>1</sub>/FVC 63%,FEV<sub>1</sub>% 70%。腹部检查,患者左腰部可见一个直径6x5cm可复性肿块。腹部CT证实腰疝。病人随后进行了疝修补术,随访2年,恢复良好。结论:腰疝是一种罕见的疾病。慢性阻塞性肺疾病患者的一些共性如:老年,营养状况差,慢性咳嗽等可能对腰疝的发生起了一定的促进作用。
英文摘要:
      objective: to explore the relationship between chronic obstructive pulmonary disease (COPD) and lumbar hernia. Methods the diagnosis and treatment of 2 patients with chronic obstructive pulmonary disease complicated with lumbar hernia were analyzed retrospectively,the clinical features of the diseases were reviewed by literatures. Results: Case 1: A male with repeated cough and shortness of breath for seven years presented to our pulmonary center. Pulmonary function tests showed that FEV<sub>1</sub>/FVC was 60% (normal ≥ 70%) and FEV<sub>1</sub>% was 55% (normal ≥ 80%). Chest Computed tomography (CT)scan showed significant emphysematous changes in his lung. The diagnosis of COPD was established. On abdominal examination, there was a 6x4cm retractable swelling in the right lumbar region. Abdomen CT scan confirmed the presence of right lumbar hernia containing fatty tissue. After symptomatic treatment, his respiratory symptoms improved obviously. The patient refused operation and was discharged from the hospital one week later. Case 2: The patient presented with gradually increasing painless and reducible left flank mass for the past two years. He had a medical history of COPD. SHis pulmonary function tests revealed that FEV<sub>1</sub>/FVC was 63% and FEV<sub>1</sub>% was 70%. On abdominal examination, there was a 6x5cm reducible swelling in the left lumbar region. CT scan of the abdomen confirmed the presence of left lumbar hernia containing fatty tissue. The patient was placed in a left lateral position of routine primary repair. The result of his surgical repair was good with no recurrence in the follow-up of 2 years. Conclusions: Lumbar hernia is a rare disease. Some common features of patients with COPD such as old age, poor nutritional status, chronic cough and other factors would contribute to the occurrence of lumbar hernia.
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